回收式自体输血和血液保存对红细胞超微形态和免疫功能的影响
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摘要
目 的：通过观察红细胞超微形态和检测红细胞C3b受体花环形成率（RBC-C3bRR）、红细胞免疫复合物花环形成率（RBC-ICR）、表达CD35阳性的红细胞百分率、红细胞超氧化物歧化酶（superoxide dismutase,SOD）含量，探讨术中回收式自体输血（intraoperative autotransfusion,IAT）和血液保存对红细胞超微形态和免疫功能的影响。
方 法：随机选取预计术中出血量在600mL以上的手术患者50例，年龄(25～69)岁，体重（35～82）kg，ASA I-III级，肾功能正常，无血液疾病、自身免疫性疾病及内分泌疾病，近期未进行过放疗、化疗及应用免疫抑制剂。选用静吸复合全麻，以芬太尼、依托咪酯和琥珀胆碱快速诱导气管插管，术中用芬太尼、异丙酚、维库溴铵和异氟醚维持麻醉。术中出血采用ZITI-2000型血液回收机（北京京精医疗有限公司）进行IAT。抽取50例IAT回收浓缩红细胞各1mL为I组；抽取50例患者术野血各2mL，离心后取红细胞为II组；抽取50例用枸橼酸-磷酸-葡萄糖-腺嘌呤（CPDA）保养液保存两周的库存浓缩红细胞各1mL为III组。
样本经2.5%戊二醛固定、双蒸水清洗、乙醇梯度脱水、叔丁醇干燥、离子金属镀膜，用日立HITACHI S-3500型扫描电子显微镜观察红细胞，随机选取5个细胞疏密程度适中的放大1000-3000倍的视野存储图像。统计各视野双凹圆盘
形红细胞(discocyte)、棘形红细胞(echinocyte)和口形红细胞(stomatocyte)的百分率。
将补体致敏酵母菌和补体未致敏酵母菌试剂按红细胞计数法配成1×108/mL备用。三组红细胞按红细胞计数法配成1.25×107/mL备用。测定方法：取两支试管，每管加红细胞悬液50μL，第一管加补体致敏酵母菌50μL，第二管加补体未致敏酵母菌50μL，混匀，37℃水浴30min，取出加0.25%戊二醛50μL固定，水平涂片瑞氏染色，在显微镜下计数200个红细胞，一个红细胞结合两个或以上酵母菌为一朵花环，计算百分率，第一管为RBC-C3b受体花环形成率（RBC-C3bRR，%），第二管为RBC-免疫复合物花环形成率（RBC-ICR，%）。
取流式细胞仪专用管两支，第一管加入IgG1-FITC/IgG2-PE鼠抗人单克隆抗体5μL，第二管加入CD35-FITC单克隆抗体5μL，两管分别加入红细胞悬液5μL，前者为阴性对照。两管充分摇匀，置4℃冰箱15min，再加入生理盐水0.5mL，混匀后上流式细胞仪，计数50000个红细胞，测定表达CD35阳性的红细胞百分率。
取若干放射免疫测定专用试管进行标号，包括NSB管、S0-S5管及待测样品管。测定方法：第一步：NSB管加入S0100μL，S0-S5管分别加入S0-S5各100μL，样品管加待测样品100μL；第二步：各管分别加入125I-SOD 100μL；第三步：NSB管加入蒸馏水100μL，S0-S5管和样品管加入兔抗SOD血清各100μL，混匀后4℃过夜；第四步：各管加入驴抗兔免疫分离剂500μL， 摇匀， 室温放置15min后，以3500rpm·min-1离心5min，吸弃上清液，用γ放射免疫计数仪测定各管的放射性计数，由电脑自动处理得出红细胞SOD
含量，以ng·mL-1表示。
所有数据以 ±s表示，用SPSS10.0进行统计学处理，I组与II组比较采用配对t-检验；I组与III组、II组与III组比较采用两样本t-检验，各指标用Pearson Correlation进行相关分析。P<0.05为差异有显著性意义, P<0.01为差异有非常显著性意义。
结 果：1 红细胞超微形态的观察：双凹圆盘形红细胞率、棘形红细胞率和口形红细胞率I组分别为50.62±7.69%、29.07±5.25%和8.52±1.04%，II组分别为59.58±7.82%、24.98±6.73%和7.09±1.30%。双凹圆盘形红细胞率I组低于II组，棘形红细胞率和口形红细胞率I组高于II组，但差异均无显著性意义（P>0.05）。III组的双凹圆盘形红细胞率和棘形红细胞率分别为21.48±3.79%和59.53±7.51%，与其它两组相比，差异均有非常显著性意义（P<0.01）。口形红细胞率III组与其它两组相比差异无显著性意义（P>.05）。
2 红细胞免疫粘附功能：I组、II组、III组RBC-C3bRR分别为11.68±3.45%、14.80±3.76%、9.38±1.90%。I组与III组RBC-C3bRR均明显低于II组，差异有非常显著性意义（P<0.01）。I组RBC-C3bRR明显高于III组，差异有显著性意义（P<0.05）。三组RBC-ICR差异无显著性意义（P>.05）。
3 表达CD35阳性的红细胞百分率：I组和III组分别为6.31±2.95%和3.74±1.89%，与II组（9.73±3.91%）相比明显降低，差异有非常显著性意义（P<0.01），但I组明显高于III组，差异有非常显著性意义（P<0.01）。
4 红细胞SOD含量：I组和III组分别为268.42±22.62 ng·mL-1 和205.44±17.84 ng·mL-1，与II组（350.65±26.24 ng· mL-1）相比明显减少，差异有显著性意义（P<0.05和 P<0.01）。III组明显低于I组，差异有显著性意义（P<0.05）。
5 相关分析：双凹圆盘形红细胞率与RBC-C3bRR、表达CD35阳性的红细胞百分率及SOD含量均成正相关，但均无显著性意义（P>0.05）。红细胞SOD含量与表达CD35阳性的红细胞百分率成正相关，有显著性意义（r=0.248，P=0.018）。
结 论：洗涤式自体血液回收对红细胞免疫功能有一定程度的损害，对回收红细胞超微形态的影响较轻，但仍有一定的临床意义，血液回收技术应进一步提高改进。回收红细胞的超微形态和免疫?
Objective: To observe the effects of intraoperative autotransfusion(IAT) and blood preservation on erythrocyte ultrastructure and immune ability by determining erythrocyte ultrastructure, the rosette rate of RBC-C3b receptor,the rosette rate of RBC-immune complex, the percent of CD35-positive erythrocytes and the content of erythrocyte superoxide dismutase.
Methods: Fifty ASAI-III patients(22 Male, 28 Female) aged 25～69 years old , weighing 35～82 kg , whose lost blood volume was more than 600mL during operations were studied. Their kidneys’ functions were normal.They had no hematologic diseases, autoimmune diseases or endocrine diseases and were not received radiotherapy, chemotherapy or immunodepressive agents recently. Anesthesia was induced with fentanyl 3～5μg·kg-1, etomidate 0.2～0.3mg· kg-1 and scoline 1～2mg·kg-1. After tracheal intubation, anesthesia was maintained with fentanyl, propofol, vecuronium and isoflurane. The ZITI-2000 type autotransfusion system was used to salvage the lost blood during the operation. The study subjects were divided into three groups. Group I was salvaged erythrocyte (n=50); group II was
erythrocyte of the surgery field of the same patient (n=50); group III was banked erythrocyte(n=50) stored in citrate-phosphate-dextrose-adenine anticoagulant solution for two weeks.
The sample was fixed with 2.5% glutaraldehyde. After fixation, erythrocytes were washed three times with double distilled water, dehydrated in ascending concentrations of ethanol and dried with Tert-butyl alcohol. After drying, erythrocytes were coated with gold. Five iso-distributed fields at ×1000～3000 were randomly selected and saved under scanning electron microscope.The percent of discocytes, echinocytes and stomatocytes was counted in each field.
The complement–sensitized yeasts and the complement- unsensitized yeasts were lysed to 1×108/mL based on the erythrometry. Erythrocytes of three groups were diluted to 1.25×107/mL based on the erythrometry. Take two test tubes and fifty microlites of erythrocyte suspension (1.25×107/mL) were added into each tube. Fifty microlites of complement-sensitized yeasts (1×108/mL) and unsensitized yeasts (1×108/mL) were differently put into the first and second tube. Each tube was iso-mixed, put into water bath(37℃) for thirty minutes, fixed with 0.25% glutaraldehyde, smeared and stained with Wright’s staining. Two hundred erythrocytes were counted under light microscope. One rosette was an erythrocyte binding two or above yeastes and the percent was counted.The first tube was the rosette rate of RBC-C3b receptor(RBC-C3bRR，%) and the
second tube was the rosette rate of RBC-immune complex (RBC-ICR，%)。
Take two test tubes used specially for flow cytometer. Five microlites of erythrocyte suspension were added into each tube. Five microlites of IgG1-FITC/IgG2-PE monoclonal antibody and CD35-FITC monoclonal antibody were put into the first and second tube. The first tube was negative control. Each tube was iso-mixed, put into the refrigeratory(4℃) for fifteen minutes, added into half of one milliliter of normal saline and measured with flow cytometer. Fifty thousand erythrocytes were counted and the percent of CD35-positive erythrocytes was then determined.
Test tubes used specially for radio-immunoassay were signed numbers including NSB tube, S0-S5 tubes and sample tubes.The first step：One hundred microlites of S0 were put into the NSB tube. One hundred microlites of S0-S5 were put into S0-S5 tubes differently. One hundred microlites of samples were put into sample tubes.The second step: One hundred microlites of 125I-SOD were put into each tube.The third step: One hundred microlites of distilled water were added into the NSB tube. One hundred microlites of anti-SOD blood serum were respectively added into S0-S5 tubes and sample tubes. Each tube was iso-mixed and stayed overnight at 4℃；The fourth step: Five hundred microlites of immune seperating agent were added into each tube. Each tube was iso-mixed, stayed at room temperature for
方 法：随机选取预计术中出血量在600mL以上的手术患者50例，年龄(25～69)岁，体重（35～82）kg，ASA I-III级，肾功能正常，无血液疾病、自身免疫性疾病及内分泌疾病，近期未进行过放疗、化疗及应用免疫抑制剂。选用静吸复合全麻，以芬太尼、依托咪酯和琥珀胆碱快速诱导气管插管，术中用芬太尼、异丙酚、维库溴铵和异氟醚维持麻醉。术中出血采用ZITI-2000型血液回收机（北京京精医疗有限公司）进行IAT。抽取50例IAT回收浓缩红细胞各1mL为I组；抽取50例患者术野血各2mL，离心后取红细胞为II组；抽取50例用枸橼酸-磷酸-葡萄糖-腺嘌呤（CPDA）保养液保存两周的库存浓缩红细胞各1mL为III组。
样本经2.5%戊二醛固定、双蒸水清洗、乙醇梯度脱水、叔丁醇干燥、离子金属镀膜，用日立HITACHI S-3500型扫描电子显微镜观察红细胞，随机选取5个细胞疏密程度适中的放大1000-3000倍的视野存储图像。统计各视野双凹圆盘
形红细胞(discocyte)、棘形红细胞(echinocyte)和口形红细胞(stomatocyte)的百分率。
将补体致敏酵母菌和补体未致敏酵母菌试剂按红细胞计数法配成1×108/mL备用。三组红细胞按红细胞计数法配成1.25×107/mL备用。测定方法：取两支试管，每管加红细胞悬液50μL，第一管加补体致敏酵母菌50μL，第二管加补体未致敏酵母菌50μL，混匀，37℃水浴30min，取出加0.25%戊二醛50μL固定，水平涂片瑞氏染色，在显微镜下计数200个红细胞，一个红细胞结合两个或以上酵母菌为一朵花环，计算百分率，第一管为RBC-C3b受体花环形成率（RBC-C3bRR，%），第二管为RBC-免疫复合物花环形成率（RBC-ICR，%）。
取流式细胞仪专用管两支，第一管加入IgG1-FITC/IgG2-PE鼠抗人单克隆抗体5μL，第二管加入CD35-FITC单克隆抗体5μL，两管分别加入红细胞悬液5μL，前者为阴性对照。两管充分摇匀，置4℃冰箱15min，再加入生理盐水0.5mL，混匀后上流式细胞仪，计数50000个红细胞，测定表达CD35阳性的红细胞百分率。
取若干放射免疫测定专用试管进行标号，包括NSB管、S0-S5管及待测样品管。测定方法：第一步：NSB管加入S0100μL，S0-S5管分别加入S0-S5各100μL，样品管加待测样品100μL；第二步：各管分别加入125I-SOD 100μL；第三步：NSB管加入蒸馏水100μL，S0-S5管和样品管加入兔抗SOD血清各100μL，混匀后4℃过夜；第四步：各管加入驴抗兔免疫分离剂500μL， 摇匀， 室温放置15min后，以3500rpm·min-1离心5min，吸弃上清液，用γ放射免疫计数仪测定各管的放射性计数，由电脑自动处理得出红细胞SOD
含量，以ng·mL-1表示。
所有数据以 ±s表示，用SPSS10.0进行统计学处理，I组与II组比较采用配对t-检验；I组与III组、II组与III组比较采用两样本t-检验，各指标用Pearson Correlation进行相关分析。P<0.05为差异有显著性意义, P<0.01为差异有非常显著性意义。
结 果：1 红细胞超微形态的观察：双凹圆盘形红细胞率、棘形红细胞率和口形红细胞率I组分别为50.62±7.69%、29.07±5.25%和8.52±1.04%，II组分别为59.58±7.82%、24.98±6.73%和7.09±1.30%。双凹圆盘形红细胞率I组低于II组，棘形红细胞率和口形红细胞率I组高于II组，但差异均无显著性意义（P>0.05）。III组的双凹圆盘形红细胞率和棘形红细胞率分别为21.48±3.79%和59.53±7.51%，与其它两组相比，差异均有非常显著性意义（P<0.01）。口形红细胞率III组与其它两组相比差异无显著性意义（P>.05）。
2 红细胞免疫粘附功能：I组、II组、III组RBC-C3bRR分别为11.68±3.45%、14.80±3.76%、9.38±1.90%。I组与III组RBC-C3bRR均明显低于II组，差异有非常显著性意义（P<0.01）。I组RBC-C3bRR明显高于III组，差异有显著性意义（P<0.05）。三组RBC-ICR差异无显著性意义（P>.05）。
3 表达CD35阳性的红细胞百分率：I组和III组分别为6.31±2.95%和3.74±1.89%，与II组（9.73±3.91%）相比明显降低，差异有非常显著性意义（P<0.01），但I组明显高于III组，差异有非常显著性意义（P<0.01）。
4 红细胞SOD含量：I组和III组分别为268.42±22.62 ng·mL-1 和205.44±17.84 ng·mL-1，与II组（350.65±26.24 ng· mL-1）相比明显减少，差异有显著性意义（P<0.05和 P<0.01）。III组明显低于I组，差异有显著性意义（P<0.05）。
5 相关分析：双凹圆盘形红细胞率与RBC-C3bRR、表达CD35阳性的红细胞百分率及SOD含量均成正相关，但均无显著性意义（P>0.05）。红细胞SOD含量与表达CD35阳性的红细胞百分率成正相关，有显著性意义（r=0.248，P=0.018）。
结 论：洗涤式自体血液回收对红细胞免疫功能有一定程度的损害，对回收红细胞超微形态的影响较轻，但仍有一定的临床意义，血液回收技术应进一步提高改进。回收红细胞的超微形态和免疫?
Objective: To observe the effects of intraoperative autotransfusion(IAT) and blood preservation on erythrocyte ultrastructure and immune ability by determining erythrocyte ultrastructure, the rosette rate of RBC-C3b receptor,the rosette rate of RBC-immune complex, the percent of CD35-positive erythrocytes and the content of erythrocyte superoxide dismutase.
Methods: Fifty ASAI-III patients(22 Male, 28 Female) aged 25～69 years old , weighing 35～82 kg , whose lost blood volume was more than 600mL during operations were studied. Their kidneys’ functions were normal.They had no hematologic diseases, autoimmune diseases or endocrine diseases and were not received radiotherapy, chemotherapy or immunodepressive agents recently. Anesthesia was induced with fentanyl 3～5μg·kg-1, etomidate 0.2～0.3mg· kg-1 and scoline 1～2mg·kg-1. After tracheal intubation, anesthesia was maintained with fentanyl, propofol, vecuronium and isoflurane. The ZITI-2000 type autotransfusion system was used to salvage the lost blood during the operation. The study subjects were divided into three groups. Group I was salvaged erythrocyte (n=50); group II was
erythrocyte of the surgery field of the same patient (n=50); group III was banked erythrocyte(n=50) stored in citrate-phosphate-dextrose-adenine anticoagulant solution for two weeks.
The sample was fixed with 2.5% glutaraldehyde. After fixation, erythrocytes were washed three times with double distilled water, dehydrated in ascending concentrations of ethanol and dried with Tert-butyl alcohol. After drying, erythrocytes were coated with gold. Five iso-distributed fields at ×1000～3000 were randomly selected and saved under scanning electron microscope.The percent of discocytes, echinocytes and stomatocytes was counted in each field.
The complement–sensitized yeasts and the complement- unsensitized yeasts were lysed to 1×108/mL based on the erythrometry. Erythrocytes of three groups were diluted to 1.25×107/mL based on the erythrometry. Take two test tubes and fifty microlites of erythrocyte suspension (1.25×107/mL) were added into each tube. Fifty microlites of complement-sensitized yeasts (1×108/mL) and unsensitized yeasts (1×108/mL) were differently put into the first and second tube. Each tube was iso-mixed, put into water bath(37℃) for thirty minutes, fixed with 0.25% glutaraldehyde, smeared and stained with Wright’s staining. Two hundred erythrocytes were counted under light microscope. One rosette was an erythrocyte binding two or above yeastes and the percent was counted.The first tube was the rosette rate of RBC-C3b receptor(RBC-C3bRR，%) and the
second tube was the rosette rate of RBC-immune complex (RBC-ICR，%)。
Take two test tubes used specially for flow cytometer. Five microlites of erythrocyte suspension were added into each tube. Five microlites of IgG1-FITC/IgG2-PE monoclonal antibody and CD35-FITC monoclonal antibody were put into the first and second tube. The first tube was negative control. Each tube was iso-mixed, put into the refrigeratory(4℃) for fifteen minutes, added into half of one milliliter of normal saline and measured with flow cytometer. Fifty thousand erythrocytes were counted and the percent of CD35-positive erythrocytes was then determined.
Test tubes used specially for radio-immunoassay were signed numbers including NSB tube, S0-S5 tubes and sample tubes.The first step：One hundred microlites of S0 were put into the NSB tube. One hundred microlites of S0-S5 were put into S0-S5 tubes differently. One hundred microlites of samples were put into sample tubes.The second step: One hundred microlites of 125I-SOD were put into each tube.The third step: One hundred microlites of distilled water were added into the NSB tube. One hundred microlites of anti-SOD blood serum were respectively added into S0-S5 tubes and sample tubes. Each tube was iso-mixed and stayed overnight at 4℃；The fourth step: Five hundred microlites of immune seperating agent were added into each tube. Each tube was iso-mixed, stayed at room temperature for
引文
1 Klein HG. Will blood transfusion ever be safe enough ? JAMA, 2000,284(2):238～240
2 Pereira A. Deleterious consquences of allogeneic blood transfusion on postoperative infection: really a transfusion-related immunomodulation effect? Blood, 2001, 98(2):498～500
3 Nitescu N,Bengtsson A,Bengtson JP. Blood salvage with a continuous autotransfusion system compared with a haemofiltration system. Perfusion,2002,17(5):357～362
4 Sebastian C,Romero R,Olla E,et al. Postoperative bloodsalvageandreinfusioninspinalsurgery:bloodquality, effectiveness and impact on patient blood parameters. Eur Spine J, 2000,9(6):458～465
5 Valeri CR,Dennis RC,Ragno G,et al. Survival, function, and hemolysis of shed red blood cells processed as nonwashed blood and washed red blood cells. Ann Thorac Surg, 2001, 72(5): 1598～1602
6 Burman JF,Westlake AS,Davidson SL,et al. Study of five cell salvage machines in coronary artery surgery. Transfus Med, 2002, 12(3):173～179
7 Serrick CJ,Scholz M,Melo A,et al. Quality of red blood cells using autotransfusion devices: a comparative analysis. J Extra Corpor Technol, 2003,35(1):28～34
8 Simpson LO. Blood from healthy animals and humans contains nondiscocytic erythrocytes. Bri J Haematol, 1989, 73(4):561～564
9 Berezina TL, Zaets SB, Morgan C,et al. Influence of storage on red blood cell rheological properties. J Surg Res , 2002; 102(1): 6～12
10 Stevenson GW,Hall SC,Rudnick S,et al. The effect of anesthetic agents on the human immune response. Anaesthesiology, 1990, 72(3): 542～552
11 李军,奚家骅,杨晋祥. 异丙酚体外对人外周血淋巴细胞功能的影响. 中华麻醉学杂志,1995,15(9):414
12 Craig ML,Bankovid AJ,Taylor RP. Visulization of the transfer reaction: tracking immune complexes from erythrocyte complement receptor 1 to macrophages. Clin Immunol, 2002, 105(1):36～47
13 Oudin S, Libyh MT, Goossens D,et al. A soluble recombinant multimeric anti-Rh(D) single-chain Fv/CR1 molecule restores the immune complex binding ability of CR1-deficient erythrocytes. J Immunol, 2000, 164 (3): 1505～1513
14 Cockburn IA,Donvito B,Cohen JH,et al. A simple method for accurate quantification of complement receptor 1 on erythrocytes preserved by fixing or freezing. J Immunol Methods, 2002, 271(1-2): 59～64
15 Tas SW, Klickstein LB, Barbashov SF, et al. C1q and C4b bind simultaneously to CR1 and additively support erythrocyte adhesion. J Immunol,1999,163(9):5056～5063
16 Imrie HJ,Jones DRE. Complement coating of erythrocytes is reduced following their interaction with neutrophils in vitro without loss of complement receptor 1(CR1). Clin Exp Immunol,1997,109 (1):217～222
17 Paccaud JP,Carpentier JL,Schifferli JA. Difference in the clustering of complement receptor type 1(CR1) on polymorphonuclear leukocytes and erythrocytes: effect on immune adherence. Eur J Immunol,1990, 20(2):283～289
18 王春景,李儒臣,马草山,等. 库存血免疫功能与存放时间关系的研究. 中国输血杂志,2002,15(1):56～57
19 Teixeira JE,Martinez R,Camara LM,et al. Expression of complement receptor type 1 (CR1) on erythrocytes of paracoccidiodomycosis patients. Mycopathologia, 2001, 152 (3)：125～133
20 Rosolski T, Matthey I, Frick U, et al. Blood seperation with two different autotransfusion devices: effects on blood cell quality and coagulation variables. Int J Artif Organs, 1998, 21(12): 820～824
21 Jozwik M, Jozwik M, Jozwik M, et al. Antioxidant defence of red blood cells and plasma in stored human blood. Clin Chim Acta,1997,267(2):129～142
22 Alleva R,Ferretti G, Borghi B, et al. Physico-chemical properties of membranes of recovered erythrocytes in blood autologous transfusion: a study using fluorescence technique. Transfus Sci, 1995, 16(3): 291～297
2 Pereira A. Deleterious consquences of allogeneic blood transfusion on postoperative infection: really a transfusion-related immunomodulation effect? Blood, 2001, 98(2):498～500
3 Nitescu N,Bengtsson A,Bengtson JP. Blood salvage with a continuous autotransfusion system compared with a haemofiltration system. Perfusion,2002,17(5):357～362
4 Sebastian C,Romero R,Olla E,et al. Postoperative bloodsalvageandreinfusioninspinalsurgery:bloodquality, effectiveness and impact on patient blood parameters. Eur Spine J, 2000,9(6):458～465
5 Valeri CR,Dennis RC,Ragno G,et al. Survival, function, and hemolysis of shed red blood cells processed as nonwashed blood and washed red blood cells. Ann Thorac Surg, 2001, 72(5): 1598～1602
6 Burman JF,Westlake AS,Davidson SL,et al. Study of five cell salvage machines in coronary artery surgery. Transfus Med, 2002, 12(3):173～179
7 Serrick CJ,Scholz M,Melo A,et al. Quality of red blood cells using autotransfusion devices: a comparative analysis. J Extra Corpor Technol, 2003,35(1):28～34
8 Simpson LO. Blood from healthy animals and humans contains nondiscocytic erythrocytes. Bri J Haematol, 1989, 73(4):561～564
9 Berezina TL, Zaets SB, Morgan C,et al. Influence of storage on red blood cell rheological properties. J Surg Res , 2002; 102(1): 6～12
10 Stevenson GW,Hall SC,Rudnick S,et al. The effect of anesthetic agents on the human immune response. Anaesthesiology, 1990, 72(3): 542～552
11 李军,奚家骅,杨晋祥. 异丙酚体外对人外周血淋巴细胞功能的影响. 中华麻醉学杂志,1995,15(9):414
12 Craig ML,Bankovid AJ,Taylor RP. Visulization of the transfer reaction: tracking immune complexes from erythrocyte complement receptor 1 to macrophages. Clin Immunol, 2002, 105(1):36～47
13 Oudin S, Libyh MT, Goossens D,et al. A soluble recombinant multimeric anti-Rh(D) single-chain Fv/CR1 molecule restores the immune complex binding ability of CR1-deficient erythrocytes. J Immunol, 2000, 164 (3): 1505～1513
14 Cockburn IA,Donvito B,Cohen JH,et al. A simple method for accurate quantification of complement receptor 1 on erythrocytes preserved by fixing or freezing. J Immunol Methods, 2002, 271(1-2): 59～64
15 Tas SW, Klickstein LB, Barbashov SF, et al. C1q and C4b bind simultaneously to CR1 and additively support erythrocyte adhesion. J Immunol,1999,163(9):5056～5063
16 Imrie HJ,Jones DRE. Complement coating of erythrocytes is reduced following their interaction with neutrophils in vitro without loss of complement receptor 1(CR1). Clin Exp Immunol,1997,109 (1):217～222
17 Paccaud JP,Carpentier JL,Schifferli JA. Difference in the clustering of complement receptor type 1(CR1) on polymorphonuclear leukocytes and erythrocytes: effect on immune adherence. Eur J Immunol,1990, 20(2):283～289
18 王春景,李儒臣,马草山,等. 库存血免疫功能与存放时间关系的研究. 中国输血杂志,2002,15(1):56～57
19 Teixeira JE,Martinez R,Camara LM,et al. Expression of complement receptor type 1 (CR1) on erythrocytes of paracoccidiodomycosis patients. Mycopathologia, 2001, 152 (3)：125～133
20 Rosolski T, Matthey I, Frick U, et al. Blood seperation with two different autotransfusion devices: effects on blood cell quality and coagulation variables. Int J Artif Organs, 1998, 21(12): 820～824
21 Jozwik M, Jozwik M, Jozwik M, et al. Antioxidant defence of red blood cells and plasma in stored human blood. Clin Chim Acta,1997,267(2):129～142
22 Alleva R,Ferretti G, Borghi B, et al. Physico-chemical properties of membranes of recovered erythrocytes in blood autologous transfusion: a study using fluorescence technique. Transfus Sci, 1995, 16(3): 291～297
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